Hwa-Byung and EMDR: Bridging Culture and Trauma Therapy
PUBLISHED ON: July 08, 2025
WRITTEN BY: Christina Jung, LCSW, Ed.D. EMDRIA Certified EMDR Therapist and Consultant in Training
Mental health is deeply connected to culture. The ways we show pain, handle tough times, and look for healing are shaped by the values, expectations, and traditions we carry. One powerful example of this is Hwa-byung, or “fire illness”—a culture-bound syndrome recognized in Korean culture and now acknowledged by Western psychiatry (Chan-Young et al., 2024).
It is characterized by intense emotional distress and physical symptoms related to suppressed anger, frustration, and helplessness, often displayed through chest tightness, heat sensation, and globus pharyngeus (a feeling of a lump in the throat). Research recommends that therapeutic interventions addressing the emotional and physical aspects of Hwa-byung must be approached distinctly (Hye et al., 2024).
My Journey with Hwa-Byung
Coming to the U.S. from Korea, I wasn’t immune to the emotional weight of suppressed emotions. I’ve lived it myself. I’ve seen it in my family, my friends, and my clients—people dealing with ongoing physical symptoms like chest pain, fatigue, or tension, even when they knew their struggles had emotional roots.
While Hwa-byung is rooted in Korean culture, it reflects a universal human experience. The toll of holding in strong feelings can show up in anyone, not just those from Korean culture. Suppressed emotions are part of the human experience, and when they’re not processed, they tend to show up through the body.
Understanding Hwa-Byung (Fire Illness)
The term Hwa-byung can be traced back to 18th-century historical texts, including accounts related to the wife of Crown Prince Sado (Lee et al., 2004).
Common symptoms include:
Emotional distress: feelings of unfairness, deep resentment, or rage
Physical symptoms: chest tightness, palpitations, hot flashes, dry mouth, globus sensation
Behaviors: sighing, crying, or sudden emotional outbursts
A Culturally Informed Approach to Healing
Recognizing Hwa-byung in therapy is important—not just for making an accurate diagnosis, but for providing care that’s culturally sensitive and responsive. Research suggests that effective treatment may include approaches such as cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), family-based interventions, and even traditional herbal medicine (Choi et al., 2021). When we view Hwa-byung through both a cultural and trauma-informed lens, we are better able to support those experiencing it, and we begin to see more clearly how culture influences the ways we feel, express, and hold emotional pain.
The Cultural Mirror: What Korean Dramas Reveal About Suppressed Emotions
Korean culture has become a global favorite in recent years, thanks to K-dramas, K-pop, and the wider Korean Wave. From spicy tteokbokki and crispy fried chicken to facial masks and heartfelt ballads, Korean media gives us a lively picture of modern life. However, look closely, and you’ll also see something deeper—emotional patterns and family dynamics that say a lot about how feelings are handled.
Have you ever noticed how characters—especially women—express anger, sadness, or frustration?
It’s not uncommon in Korean dramas to see women showing their distress through physical symptoms: fainting, clutching their chest, describing a feeling of heat rising, or suddenly needing medical care. You might see a character dramatically fanning herself, hitting her chest, sighing deeply, or screaming. These behaviors mirror what we now recognize clinically as symptoms of Hwa-byung.
On the other hand, you will also notice women suppressing their emotions, displaying a flat affect, or brushing off their needs to maintain family harmony. These portrayals reflect the emotional restraint that is deeply ingrained in Korean cultural values, particularly among women.
So next time you watch a K-drama, look beyond the love triangles—you might catch a glimpse of the psychosomatic language of emotion that is still very much alive in Korean culture today.
Why EMDR Matters for Hwa-Byung
One of the reasons EMDR is particularly suitable for Koreans and Asian clients is that it does not rely heavily on verbal expression or emotional disclosure, which can be uncomfortable or culturally inappropriate for clients who were raised in environments that value emotional control and familial harmony. EMDR works with the body’s language-accessing memories through somatic experiences, not just thoughts or words.
Some clients are already aware of somatic symptoms they want to target in EMDR. However, in my practice, I’ve also observed that Hwa-byung symptoms are often hidden, unspoken, or minimized, a pattern reinforced by cultural messaging that encourages individuals to “push through” or “don't make trouble.”
This is where cultural attunement becomes critical. Rather than asking clients to fit a Western model of emotional expression, we adjust our methods to meet them within their cultural frameworks. (Nickerson,2017). EMDR enables this attunement by providing multiple channels for healing, not just through cognitive or emotional recall, but also through the body. This provides a safe space for somatic symptoms, such as chest tightness or heat, to emerge and resolve.
In one case, a client came in to address a recent traumatic event and its impact on daily functioning. As we went through the phases of EMDR, she recalled childhood memories of being silenced and unseen, tied to negative beliefs about herself. Although she had never shown any overt physical signs of Hwa-byung initially, symptoms briefly emerged, characterized by a tight and hot sensation around the chest, and then released, following EMDR’s natural desensitization process. What had been held silently for decades was finally given voice not through words but through the body’s own healing ability. This client found a greater sense of self through calmness, relief, and a sense of being more in control, demonstrating the potential for empowerment through EMDR.
EMDR Therapy: Rewiring the Brain’s Response to Trauma
Trauma is something many of us experience in different forms. It includes moments that feel too overwhelming to process, often bringing up painful emotions like shame or fear, and leaving us feeling vulnerable or powerless. Over time, especially during crucial stages of growth, these experiences can build up and deeply affect how we think, feel, and relate to the world.
Developed by Francine Shapiro, PhD, EMDR is a structured, research-supported therapy originally designed to treat PTSD. Today, it is widely used to address a range of challenges—such as depression, anxiety, and somatic disorders—that may stem from or occur alongside traumatic experiences (Shapiro, 2014). During EMDR sessions, clients briefly focus on distressing memories—without needing to talk about them in detail—while engaging in bilateral stimulation (usually eye movements), allowing the brain to resume its natural healing process.
How EMDR helps:
It helps reprocess painful memories
It reduces the emotional and physical intensity of those memories.
It helps clients regain a sense of control and resolution.
Instead of relying solely on talking (which may not be easy or natural in every culture), EMDR helps the body release what it has been holding, something significant in cultures where emotional expression may be more internalized.
Final Reflections
Hwa-byung invites us to see the whole picture. EMDR offers a path toward healing that honors both the mind and the body, especially for those whose pain has been quiet, hidden, or misunderstood.
As someone who has both lived this experience and supported others through it, I believe deeply in bridging traditional cultural impact with trauma-informed therapy. Whether you are from a Korean background or not, if you are carrying pain, EMDR may be a meaningful step toward release, resilience, and healing.
Let’s Connect
Christina is an EMDRIA Certified EMDR Therapist & Consultant in Training. If you or a loved one is curious about EMDR or ready to explore support, we welcome you to reach out to us at Defining Moments Counseling and Assessment Center.
To learn more about EMDR and the research behind it, visit the EMDR International Association:
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Chan-Young, K., & Lee, B. (2024). Effectiveness of mind-body medicine for Hwa-byung (a Korean cultural diagnosis of suppressed anger): A systematic review. Complementary Therapies in Medicine, 80.
Choi, Y., Kim, Y., Kwon, O., Chung, S. Y., & Cho, S. H. (2021). Effect of herbal medicine (Huanglian-jie-du granule) for somatic symptoms and insomnia in patients with Hwa-byung: A randomized controlled trial. Integrative medicine research, 10(2), 100453.
Hye, J. K., Kang, D. H., Park, Y. C., Kim, N. K., Kang, H. W., & In, C. J. (2024). Efficacy and safety of virtual reality-based versus traditional emotion-to-emotion therapy for treatment of hwa-byung. Healthcare, 12(23), 2407. https://doi.org/10.3390/healthcare12232407
Lee, Y.S., Kim, K. H., Kim, S. Y., & Kim, B.T. (2004). Hwabyung- An overview. Psychiatry Investigation, 1(1), 21-24.
Maxfield, L. (2019). A clinician’s guide to the efficacy of EMDR therapy. Journal of EMDR Practice and Research, 13(4), 239–246.
Nickerson, M. I. (2017). Cultural competence and healing culturally-based trauma with EMDR therapy : innovative strategies and protocols. Springer Publishing Company, LLC.
Shapiro F. (2014). The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. The Permanente journal, 18(1), 71–77.
Please note: The views expressed in this article are those of the author and may or may not necessarily represent the perspectives of our group practice.